|Table of Contents|

Comparison of the efficacy and safety of ultrasound-guided microwave and radiofrequency ablation for the treatment of papillary thyroid microcarcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2025 06
Page:
975-981
Research Field:
Publishing date:

Info

Title:
Comparison of the efficacy and safety of ultrasound-guided microwave and radiofrequency ablation for the treatment of papillary thyroid microcarcinoma
Author(s):
WANG Shuanglong; LYU Shaowen; WANG Beibei; PANG Hui; GAO Xiaohong; WANG Qian; KONG Qingfeng
Department of Ultrasound,Jining No.1 People’s Hospital,Shandong Jining 272000,China.
Keywords:
papillary thyroid microcarcinoma; radiofrequency ablation; microwave ablation; efficacy; safety; comparative study
PACS:
R736.1
DOI:
10.3969/j.issn.1672-4992.2025.06.013
Abstract:
Objective:To compare and analyze of the efficacy and safety of ultrasound-guided radiofrequency ablation and microwave ablation for the treatment of papillary thyroid microcarcinoma.Methods:A total of 220 patients with papillary thyroid microcarcinoma (PTMC) treated with ultrasound-guided radiofrequency ablation (RFA) and microwave ablation (MWA) from May 2020 to May 2023 in our hospital were retrospectively analyzed.Patients were 220 cases,which were categorized into the RFA group (98 cases) and the MWA group (122 cases) according to the ablation methods.We compared the ablation time,the amount of water-isolating fluid,the range of vaporization of the ablation zone during the procedure (Vgas),the range of nonenhancement of ultrasonography at 1 hour after the procedure (V1 h),the difference between the intraoperative determination and the actual ablation range (Vintrao=Vgas-V1 h),the rate of volume reduction in the ablation zone after the procedure,the rate of complications,and the postprocedural cervical lymph node metastasis incidence.Results:The lesions in both groups were completely ablated,and the differences in clinical data and ultrasonographic characteristics of the lesions in the two groups were not statistically significant (P＜0.05).The ablation time,the difference between intraoperative determination and the actual ablation range (Vintrao=V1 h-Vgas) in the RFA group were greater than those in the MWA group (P＜0.05).The amount of water isolation,intraoperative vaporization range of the ablation area (Vgas),and the unenhanced range of postoperative ultrasonography at 1 hour (V1 h) in the RFA group were smaller than those in the MWA group (P＜0.05).The total number of cases of hoarseness occurred in 4 cases in the RFA group,which was more than that of the 2 cases in the MWA group,and the difference was not statistically significant (P＞0.05).The volume reduction of the ablation area was larger than that of the MWA group in the RFA group in the 1-,3-,6-,and 12-month periods after the ablation operation (all P＜0.05).The rate of complete resorption of the ablation area from follow-up to 12 months was greater in the RFA than in the MWA group (P＜0.05).During the follow-up period,one patient in the RFA group and one patient in the MWA group who did not undergo TSH inhibition as required was confirmed to have lymph node metastasis by puncture.Conclusion:Ultrasound-guided RFA and MWA are both effective and safe techniques for the treatment of papillary thyroid microcarcinoma.TSH suppression therapy is useful in preventing lymph node metastasis.RFA has a higher absorption efficiency in the ablation zone,but the intraoperative determination of the extent of ablative necrosis based on the extent of vaporization is not as accurate as that of MWA.

References:

［1］杨婷婷,苏艳军，程若川，等.我国新旧版《甲状腺结节和分化型甲状腺癌诊治指南》-外科视角的比较［J］.肿瘤防治研究,2024,51(01):16-21.YANG TT,SU YJ,CHENG RC,et al.Comparison of new and old versions of guidelines for diagnosis and treatment of thyroid nodules and differentiated thyroid carcinoma in China from a surgical perspective［J］.Cancer Research on Prevention and Treatment,2024,51(01):16-21.
[2]于明安，范卫君.甲状腺乳头状癌热消融治疗专家共识（2024版）［J］.中华内科杂志，2024，63(04):355-364.YU MA,FAN WJ.Expert consensus on thermal ablation of papillary thyroid cancer (2024 edition)［J］.Chinese Journal of Internal Medicine,2024，63(04):355-364.
[3]中华人民共和国国家卫生健康委员会医政医管局.甲状腺癌诊疗指南（2022年版）［J］.中国实用外科杂志，2022,42(12):1343-1357,1363.Medical Administration of the State Health Commission of the People’s Republic of China.Thyroid Cancer Guidelines(2022 edition)［J］.Chinese Journal of Practical Surgery,2022,42(12):1343-1357,1363.
[4]YAN L,LIU Y,LI W,et al.Long-term outcomes of ultrasound-guided thermal ablation for the treatment of solitary low-risk papillary thyroid microcarcinoma:a multicenter retrospective study［J］.Ann Surg,2023,277(5):846-853.
[5]CAO XJ,LIU J,ZHU YL,et al.Efficacy and safety of thermalablation for solitary T1bN0M0 papillary thyroidcarcinoma:A multicenter study［J］.J Clin Endocrinol Metab,2021,106(2):e573-e581.
[6]YAN L,LI Y,LI XY,et al.Clinical outcomes of ultrasound-guided radiofrequency ablation for solitary T1N0M0 papillary thyroid carcinoma:A retrospective study with more than 5 years of follow-up［J］.Cancer,2023,129(16):2469-2478.
[7]彭卫，段波峰，张明帅,等.微波消融和射频消融治疗甲状腺良性结节的疗效和安全性比较［J］.中国医师杂志,2022,24(11):1670-1673.PENG W,DUAN BF,ZHANG MS,et al.Comparison of efficacy and safety of microwave ablation and radiofrequency ablation for benign thyroid nodules［J］.Journal of Chinese Physician，2022，24（11）：1670-1673.
[8]葛明华,徐栋,杨安奎,等.甲状腺良性结节、微小癌及颈部转移性淋巴结热消融治疗专家共识(2018版)［J］.中国肿瘤,2018,27(10):768-773.GE MH,XV D,YANG AK,et al.Expert consensus on thermal ablation for thyroid benign nodes,microcarcinoma and metastatic cervical lymph nodes (2018 edition)［J］.China Cancer，2018，27(10):768-773.
[9]佘靖雯,覃夏川,段亚阳,等.超声影像组学模型预测直径≤1 cm的单发甲状腺乳头状癌中央淋巴结转移的应用价值［J］.现代肿瘤医学,2024,32(06):1115-1120.SHE JW,TAN XC,DUAN YY,et al.The application value of ultrasound radiomics model in predicting central lymph node metastasis of single papillary thyroid carcinoma with diameter ≤1 cm［J］.Modern Oncology,2024,32(06):1115-1120.
[10]HAN ZY,DOU JP,ZHENG L,et al.Safety and efficacy of microwave ablation for the treatment of low-risk papillary thyroid microcarcinoma:a prospective multicenter study［J］.Eur Radiol，2023,33(11):7942-7951.
[11]LI N,DONG Y,DING Y,et al.Comparison of the efficacy and safety of ultrasound-guided radiofrequency ablation and microwave ablation for the treatment of unifocal papillary thyroid microcarcinoma:a retrospective study［J］.Int J Hyperthermia,2024,41(1):2287964.
[12]潘春勤,周学才,彭莉,等.微波消融与射频消融治疗慢性肾脏病合并SHPT的疗效及安全性比较［J］.中国临床研究,2021,34(04):497-500.PAN CQ,ZHOU XC,PENG L,et al.Microwave ablation versus radiofrequency ablation for patients with chronic kidney disease complicated with SHPT［J］.Chinese Journal of Clinical Research,2021,34(04):497-500.
[13]SHI JW,HHUANG Y.Comparison of the ablation and hyperechoic zones in different tissues using microwave and radio frequency ablation［J］.J Ultrasound Med,2019,38(10):2611-2619.
[14]李倩倩,周平.微波、射频及激光在离体猪甲状腺消融实验的对比研究［J］.中国普通外科杂志,2016,25(05):675-679.LI QQ,ZHOU P.Comparative experiment of microwave,radio frequency and laser ablation of pig thyroid in vitro［J］.China Journal of General Surgery,2016,25(05):675-679.
[15]CERIT MN,YUCEL C,CERIT ET,et al.Comparison of the efficiency of radiofrequency and microwave ablation methods in the treatment of benign thyroid nodules［J］.Acad Radiol,2023,30(10):2172-2180.

Memo

Memo:
山东省医务职工科技创新计划联合立项项目（编号：SDYWZGKCJHLH2023074）；山东省济宁市科技助推新旧动能转换计划项目（编号：2017SMNS011）;山东省济宁市重点研发计划项目(编号：2024YXNS174)
Last Update: 1900-01-01